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Sex Differences and Gender Diversity in Stress Responses and Allostatic Load Among Workers and LGBT People


Measuring biological sex differences and socio-cultural gender diversity provides insights into individual variation in stress physiology and the development of “sex-specific” diseases.

Purpose of Review

In this selective review, we summarize recent findings that assess sex and gender in relation to the stress hormone cortisol and multi-systemic physiological dysregulation called allostatic load. The focus of this research centers on workers as well as sexual and gender minorities as these populations provide unique insights into sex and gender at various levels of analysis from the micro-level to the macro-level.

Recent Findings

Male/female sex, sex hormones, gender identity, gender roles, and sexual orientation are all variables that are distinctly correlated with stress physiology. Beyond identifying patterns of vulnerability to stress-related diseases, pathways towards resilience are of high priority in emerging literature.


Stress scientists must account for both sex and gender in biobehavioral research. Future directions should assess macro-level constructs like institutionalized gender, occupational sex composition, and structural stigma to better understand the social determinants of health.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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The corresponding author thanks Sonia Lupien for her mentorship.


Funding for this article is supported by la Foundation of l'Institut universitaire en santé mentale de Montréal (Montreal Mental Health University Institute) as well as by les Fonds de la recherche en santé du Québec (Quebec Health Research Fund).

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Correspondence to Robert-Paul Juster.

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Juster, RP., de Torre, M.B., Kerr, P. et al. Sex Differences and Gender Diversity in Stress Responses and Allostatic Load Among Workers and LGBT People. Curr Psychiatry Rep 21, 110 (2019).

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  • Biological sex
  • Socio-cultural gender
  • Allostatic load
  • Cortisol
  • Chronic stress
  • Resilience